Jong Gwo-Ping, Chen Hung-Yi, Li Shu-Yi, Liou Yi-sheng
1] Department of Internal Medicine, Chung Shan Medical University Hospital and Chung Shan Medical University, Taichung, Taiwan, ROC [2] Department of Basic Science, Central Taiwan University of Science and Technology, Taichung, Taiwan, ROC.
Institute of Pharmacy, China Medical University, Taichung, Taiwan, ROC.
Hypertens Res. 2014 Oct;37(10):950-3. doi: 10.1038/hr.2014.104. Epub 2014 Jun 26.
Antihypertensive drugs have been linked to new-onset atrial fibrillation (NAF); however, the way in which these drugs affect the development of NAF in hypertensive patients has not been thoroughly examined. Herein, we report a population-based study in which we investigated the relationship between antihypertensive drug therapy and the risk of NAF. The population sample consisted of 47 682 hypertensive patients identified from claim forms provided to the central regional branch of the Bureau of National Health Insurance in Taiwan between January 2005 and December 2010. Prescriptions for antihypertensive drugs prescribed before the index date were retrieved from a prescription database. From these data, we estimated the hazard ratio (HR) of NAF associated with antihypertensive drug use; non-NAF subjects served as the reference group. After adjusting for age and sex, we observed that the risk of NAF was higher among the patients taking diuretics (HR, 1.39; 95% confidence interval (CI), 1.06-1.82) compared with the patients not taking diuretics. Patients who took angiotensin-converting enzyme (ACE) inhibitors (HR, 0.79; 95% CI, 0.65-0.97) showed a lower risk of developing NAF compared with the nonusers of ACE inhibitors. Angiotensin receptor blockers, alpha-blockers, beta-blockers and calcium channel blockers were not associated with a risk of NAF. The results of this study suggest that hypertensive patients who take diuretics have a significant increase in the risk of NAF, whereas patients who take ACE inhibitors are at lower risk of NAF.
抗高血压药物与新发房颤（NAF）有关；然而，这些药物影响高血压患者NAF发生发展的方式尚未得到充分研究。在此，我们报告一项基于人群的研究，其中我们调查了抗高血压药物治疗与NAF风险之间的关系。人群样本包括2005年1月至2010年12月期间从提供给台湾国民健康保险局中部地区分支机构的理赔表单中识别出的47682名高血压患者。从处方数据库中检索出索引日期之前开具的抗高血压药物处方。根据这些数据，我们估计了与使用抗高血压药物相关的NAF的风险比（HR）；非NAF受试者作为参照组。在对年龄和性别进行调整后，我们观察到，与未服用利尿剂的患者相比，服用利尿剂的患者发生NAF的风险更高（HR，1.39；95%置信区间（CI），1.06 - 1.82）。与未使用血管紧张素转换酶（ACE）抑制剂的患者相比，服用ACE抑制剂的患者（HR，0.79；95%CI，0.65 - 0.97）发生NAF的风险较低。血管紧张素受体阻滞剂、α受体阻滞剂、β受体阻滞剂和钙通道阻滞剂与NAF风险无关。这项研究的结果表明，服用利尿剂的高血压患者发生NAF的风险显著增加，而服用ACE抑制剂的患者发生NAF的风险较低。
